Handbook Will Provide A Reference For Child Care

April 09, 1989|By Phyllis Magida.

The U.S. is putting together a handbook that will allow an expectant mother to keep a detailed record of her child`s health and development from birth through age 6, including birth weight, blood type, Rh factor, weight gain and height.

This handbook will also keep a record of inoculations and explain technical things such as the DPT (diphtheria, pertussis and tetanus) shot, why it is important and when a child should get it.

``It will also provide health information to the expectant mother,`` said Rae Grad, executive director of the National Commission to Prevent Infant Mortality. ``This includes nutrition information, such as advice not to smoke or drink, explanations as to why she should check whether or not she`s been tested for Tay Sachs if she`s Jewish or sickle cell anemia if she`s black.

``The book will also explain just how crucial good nutrition is and how important it is that she discuss it with her doctor. That way, the mother can find out what questions her doctor should be asking her-does her family show any incidence of high-risk births, for example, including toxemia-and take an active part in ensuring good prenatal care for herself.``

Anne Hockett, deputy director of the commission, explained that the handbook also will ask a number of important questions on child development, including `Does the baby roll over?` and `Does he get startled when you run the vacuum cleaner near him?`

``This will allow the mother to have some idea whether the child is developing normally,`` she said, ``and whether this should be discussed with the pediatrician.``

The idea for the handbook came out of a United Nations hearing to discuss infant mortality. ``The health representatives of several countries suggested that we adopt health passbooks, similar to those in use in their own countries,`` Hockett explained. ``The Japanese, particularly, who`ve had passbooks for several years, explained that this had made a big difference in lowering their country`s rate of infant mortality.``

The passbooks (or handbooks) in use in od of the child`s health that includes such things as height, weight and immunizations.

Countries that have passbooks issue them to a woman as soon as she is pregnant. In Japan, for example, women register as soon as they are pregnant and are issued their handbook when they go for health care.

``We`d been considering adopting the passbook idea for years, but had never actually done anything about it,`` Hockett said. ``But shortly after the hearing, the national commission issued a report to Congress and to President Reagan, recommending that a passbook be adopted.``

Following that report, the commission began working on a U.S. model. Commission members used the passbooks of more than 30 countries as reference, concentrating on the Canadian, German and French passbooks as major resources- all three are considered extremely well organized, thought out and presented-but closely modeling the passbook on that used by the Japanese.

The model for the American passbook, still in draft form, is unnamed. It will measure about 5 by 7 inches, have cardboard covers and come with a plastic slipcover. ``We`ve made it small enough to be carried in a purse because we wanted it to be `user friendly,` `` Grad said. ``Ideally, a separate one will be issued to every woman who is pregnant or who has a child under age 6.``

The Japanese passbook was used as a primary model for a simple reason, she explained. ``In Japan, there`s a place for the baby`s picture, for a lock of his hair, for all the vital birth information, and for the mother to explain, in writing, how she felt about the child during the pregnancy, delivery and afterward, as he began to develop.

``The result of this is that Japanese mothers treat their children`s passbooks with reverence. It becomes a valued treasure that is passed down to the next generation with as much respect as Westerners give to thethat your doctor should be asking you (might be) next to a lock of your child`s hair. A place for your baby`s Rh factor and blood type (might be) next to his first picture. Because of this, the mother is very encouraged to make the health information a priority.``

``We take the idea of a passbook very seriously,`` said Hockett, who is hopeful that it will be adopted. The decision is up to several groups in the federal government; she declined to identify them for fear of jeopordizing the handbook`s chances.

Grad explained that America needs the passbook because the country has an inordinately high infant mortality rate. ``Japan ranks first among 36 industrialized nations, with the lowest rate-only 5 infant deaths per 1,000 live births,`` she said. ``But the U.S. ranks 19th, averaging 10 or 11 infant deaths per 1,000 live births-that`s about 40,000 children each year dying within the first year of life.``